Social mobilization, education, and prevention of the Ebola virus disease: A scoping review

With nearly a dozen recurrent outbreaks in the Democratic Republic of Congo (DRC) and Guinea over the past five years, Ebola virus disease (EVD) continues to be a global public health threat (Bourgarel and Liégeois, 2019; Kawuki et al., 2021; Wenham et al., 2021). Despite the knowledge gained on the modes of transmission and spread of EVD, prevention strategies have not yet been able to adequately protect populations and stop it (Ali et al., 2022; Delamou et al., 2021). On the contrary, outbreaks in recent years have shown that the threat is constant for populations facing different forms of environmental, health, social, and political vulnerabilities. From 2017 to 2021, the DRC faced six different outbreaks of EVD, first in Bas-Uelé province, then in Equateur Province and the eastern regions (DRC Ministry of health WHO Africa, 2019; World Health Organization, 2019). However, the DRC has consistently demonstrated a strong ability to respond quickly to Ebola outbreaks and find solutions to mobilize communities and stop the virus from spreading (DRC Ministry of health WHO Africa, 2019). With the exception of the 2018–2020 outbreak in the eastern regions of DRC in an area that has been at war for more than two decades, which complicated the response (Cénat et al., 2022b; World Health Organization, 2019). The 2018–2020 outbreak in the eastern regions of the DRC is the second largest with over 2000 deaths (65.83% case fatality rate) (World Health Organization, 2020). It has been particularly difficult to contain; and, the conflicting socio-political configurations on the ground have certainly complicated the communication of public health measures to stop the spread of the virus. Known outbreaks in Guinea in February 2021 confirm that the threats of a major epidemic remain real (Delamou et al., 2021).

These different outbreaks also testify to the inadequacy of prevention strategies and programs and their inability to generate adherence among populations. Moreover, at the end of the 2013–2016 epidemic, which resulted in >11,000 deaths, the World Health Organization expressed concern about countries' capacities to implement increased surveillance and prevention strategies (OMS, 2016). The situation in the eastern regions of the DRC also provides food for thought, because until now the weakest health systems, which are also faced with current or recent socio-political situations, have always had difficulty containing epidemic outbreaks (Abramowitz et al., 2017, Abramowitz et al., 2015). The prevention of EVD requires first strategies of mobilization, sensitization, and education of the populations in the areas at risk (Ajilore et al., 2017; Cénat et al., 2021b). Without trust in the messenger, it is difficult for these strategies to get the population to adhere to them(Abramowitz et al., 2017; Ajilore et al., 2017). Several studies have also found that socioeconomic and cultural factors and feelings of monopolization of health care systems by NGOs have hindered people's confidence in the actions taken (Anoko, 2014; Thiam et al., 2015). Other studies have reported significant gaps in information regarding prevention measures, management of suspected cases, vaccination, despite the numerous communication campaigns implemented during epidemic times (Cénat et al., 2021b; Earle-Richardson et al., 2021). However, since the epidemic of 2013–2016, different programs of health communication and social mobilization were developed in countries affected by the EVD, such as the DRC, Sierra Leone, Liberia, Nigeria, Guinea (Bedson et al., 2020; Miller et al., 2018; Roess et al., 2017; Skrip et al., 2020). Efforts were made to include social mobilization and community engagement in their EVD strategic response plans, to raise awareness among their at-risk populations and avoid the spread of the virus. Yet, the success remains mitigated, according to multiple outbreaks during the last five years.

Given the inability of health systems to prevent outbreaks of EVD, it is imperative to reflect on the effectiveness of promotion, prevention, sensitization, and community mobilization programs. This reflection requires an inventory and evaluation of programs that aim to mobilize communities to prevent outbreaks. The objective of this scoping review is to assess the current state of knowledge on awareness, education, and community mobilization programs for the prevention of EVD. This scoping review seeks to identify studies, present results, and assess the impacts of these programs on the prevention of EVD within communities.

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